Differences in Thoracolumbar Burst Fractures by Falls from Height with Associated Foot and Ankle Fractures

STUDY DESIGN: This is a retrospective clinical study. OBJECTIVES: To know how the associated foot or ankle fracture influences the fracture pattern in the thoracolumbar burst fractures caused by falls from height. SUMMARY OF LITERATURE REVIEW: There were few studies on how the foot or ankle fracture influences the thoracolumbar fracture caused by falls from height. MATERIALS AND METHODS: We reviewed 46 subjects, who underwent surgery due to burst fracture of the thoracic or lumbar region, caused by fall accidents, from May 2004 to October 2008. Among them, we defined 19 cases that had associated foot or ankle fractures as group A, and the other 27 cases as group B. We analyzed the differences of radiological and clinical findings, and functional outcomes between the two groups. RESULTS: The falling heights were higher in group A than in group B (P<0.01). Thoracolumbar junction (T11-L2) was the most common location involved in both groups, but group A had more fractures on the lower lumbar region (L3-5), relatively (p=0.03). Kyphotic deformity was more severe in group B (p=0.01) but there were no significant differences in the wedge angle, amount of canal compromise, compression rate of anterior column between both groups (p=0.08, 0.46, 0.76). More segments were fused in group B (P=0.04). Neurologic deficit was more common in group B (p=0.03), but there were many complications related with foot or ankle fractures in group A (38%).There was no significant difference in the final clinical outcome between both groups (Pain scale p= 0.48, Work scale p=1.00). CONCLUSIONS: In patients who had burst fractures in the thoracic or lumbar region associated with foot or ankle fractures, there was a tendency to increase the incidence of lower lumbar fracture, relatively. The neurologic deficits were less common in this group of patients, but there was no difference in the functional outcome.

Significance of Mal-alignment after Anterior Cervical Arthrodesis in Degenerative Cervical Spinal Disorders / 대한정형외과학회잡지

PURPOSE: The purpose of this study was to analyze the risk factors for postoperative sagittal mal-alignment after anterior cervical arthrodesis resulting from degenerative cervical disorders and its effect on radiological and clinical results. MATERIALS AND METHODS: We evaluated 50 patients who underwent anterior cervical arthrodesis for degenerative cervical disorder retrospectively. We assigned 25 patients who had sagittal mal-alignment after surgery to group A and 25 patients who had improvement of lordosis after surgery to group B. We evaluated the change of cervical lordosis, lordosis at fused segments, and lordosis at unfused segments. In addition, we evaluated radiological and clinical results. RESULTS: In group A, postoperative cervical lordosis worsened from 12.7+/-10.6 to 3.6+/-6.2degrees after surgery (p=0.002), but had recovered to 12.2+/-9.5degrees by the last Follow-up (p=0.859). In group B, cervical lordosis was improved from 9.6+/-10.5degrees to 22.5+/-9.7degrees (p=0.0003) after surgery and correction was maintained to 27.5+/-9.1degrees (p=0.0988) at the last follow up. Lordosis at fused segments were improved in both groups (p=0.001, 0.0001) but lordosis at unfused segments worsend in group A (p=0.0001). The factor associated with postoperative mal-alignment was symtoms of myelopathy (p=0.0436). Age, sex, fusion level, size of cage, and duration of symptoms were not significantly associated with postoperative changes in alignment. One nonunion occurred only in group A. Six cases of cage subsidences were found in group A, 3 cases in group B (p=0.4506). Adjacent segment degeneration was found in 8 segments in group A, 1 segment in group B (p=0.0048). The differences in clinical improvement evaluated by VAS, NDI between groups were not significant (p=0.88, p=0.91). CONCLUSION: Postoperative sagittal malalignment was a temporary and reversible change, and was not related to clinical results. However, it might be a factor in the increased incidence of adjacent segment degeneration.

Bilateral Femoral Neck Fractures in a Young Adult: A Case Report

Ipsilateral femur shaft and neck fractures are occurred by high energy trauma, usually in motor vehicle accidents or fall from a height. Simultaneous Ipsilateral femur shaft and neck fractures and contralateral femur neck fracture are not yet reported in Korea. Authors report a case of simultaneous bilateral femoral neck fractures combined with a ipsilateral femoral shaft fracture in a young adult treated with anatomical reduction, internal fixation and vascularized bone graft with a review of the literature.

Soft tissue sarcomas of the extremity / 대한정형외과학회잡지

No abstract available.

Three cases of Poland's syndrome / 대한정형외과학회잡지

No abstract available.